I have a 4 year, 4 month old son that was diagnosed with autism at 32 months. He has been in various therapies since then (ABA, speech, OT, SI). He has made progress in some areas, but I feel like his speech is stuck. His speech is basically simple requests for food items, and echolalia. When someone says, "hi matt", he repeats it. He also perseverates on words all day long, which have no significance to the situation at hand. It's like what he is saying has a secret meaning to him. He currently has about 30 words, can't answer or ask questions, initiate conversation, follow through on conversation, express likes,dislikes, or feelings. He has progressed socially, by that I mean that he makes eye contact with family members and familiar people, and will smile and give hugs. He is still unable to play with children. He has no idea what to do. He wants to interact, but usually will push them down or hug them so hard that they fall. He makes screeching noises before his approach, so I know he is excited. He also doesn't know how to play with toys at all, and has no imaginary play skills. His usual pattern of interest revolves around "tapping" with an elongated object, such as a toy sword, stick, ruler, empty plastic bottle, etc.

He is very difficult to engage in play, unless it consists of bouncing him on a ball, or jumping with him on a trampoline or bed. Of course, this type of play can't be done all day, so I have run out of ideas. He is not interested in toys, games, art, etc. He will follow through on a task in ABA, just to get the reinforcer (cookie), but then changes course once he gets the cookie.

This autism is tricky. Here is my question: Is it typical for an autistic child to progress in some areas, such as eye contact, and physical contact, but remain stagnant in language and play skills? I'm afraid that my son will crave attention so much that he will hug or push anyone because he is lacking appropriate social skills.

I hope that you can answer my question. I look forward to your response.

Hello Jen, All of our children despite having a common condition have many and varied traits. What you are describing is not that uncommon. Some therapies work better for some than others and children develop at different rates in different areas.

Have you considered your son's diet at all, or the use of supplements. Adopting a gluten free(wheat free)& casein free(dairy free) has according to some, had good results with their childs behaviour and speech.

The use of Omega 3 oils (fish oils) are also claimed to be very effective in developing brain function leading to better speech and behaviour.

These are just two of many areas that need to be looked at.

On a personal level at the time, my son of 7(he is now 11) was put on a gluten free diet. He always had great speech and a huge vocabulary(he has Asperger's) but chose very rarely to talk and almost about nothing except what he wanted to.

Very quickly we noticed a big difference. basically we couldn't get him to shut-up,lol.

Despite this, I am not 100% convinced about the GF diet. I believe that many of th efoods we had to use as substitutes and new foods had their own effect and it wasn't all down to the GF part of it.

It was very difficult implementing the diet as overnight almost all of my son's favourite foods were now off-limits. It was hard turning him down when requesting his favourite food.

Now he reads the labels on the foods to check for himself if they are OK. He still gets disappointed when being turned down over something but not by having a tantrum or meltdown.

Omega 3 oils? we couldn't get him to take it, liquid or capsule form. we mention it occassionally but he point blank refuses to try them again.

Have you tried Integrated Play Groups? When facilitated with an SLP they can have great results. It basically involves using typical peers usually 2 and 1 student with autism.

Is there anyway to involve "tapping" appropriately? Perhaps a drum or a game like musical chairs that revolves around his tapping? Everyone freezes when he stops. Help him understand that he is connected to the people around him even if he isn't actually face to face with them. Having an adult with him initially, naturally explaining what is happening? "Look, they stop moving when you stop!" or "Tap ok 1-2-3 STOP".. Tapping can be used to teach him! Teach him to count through tapping! Tap letters of the alphabet. Take turns tapping on different things with him, loud and quiet. Teach him turn taking and to wait using tapping. Incorporate Red and Green lights (or construction paper) you can transfer that into cross walks. Incoporate it into his ABA. This is what I consider an obsession. It's his main interest? Why not USE it! Perhaps he'll be the greatest drummer of all time! Or a great teaching reinforcement tool! Same with the bouncing. Teach him to jump "fast" and "slow" "high" and "low". Take turns. Teach pronouns. "I jump" "You jump". Use visual schedules to explain what you are doing and for how long.Just some thoughts! You may have done all of this already! Or it may be totally inappropriate. Oh and yes I think it's fine to be gaining in some areas and not in others. Eventually it will all come together. I figure you have to understand what is being said before you can construct things to say? Great Luck!!m

Have you looked into biomedical treatments? Many kids with ASD benefit from MB-12 injection. It sounds scary but we've been giving them for 6 months now. It's 0.05ML which is a TINY dose. You can read more about it at www.drneubrander.comHe also has video studies from kids he had no speech or had echolalia who started speaking within 2 days. My son isn't "talking" but he did start syllobals when we started MB-12. He just doesn't have his constanants down. It's really helping him though.

Regarding his speech difficulties. There are two avenues that you didn't mention. One is sign language and the other is using pictures to communicate with. Both have shown to aide in children increasing their speech. You may wish to try taking some digital pictues of things you know he wants but has difficulty asking for. Label them with the correct name. When he points to them, you repeat the name and obtain the object / food for him or, like any other parent, tell him no, later, etc. To train him, take a food object, something small, something he wants, place them in front of you and teach him to hand you the picture in order to get the food. Once learned, try it with something else. Generalizing often happens quickly but if it doesn't, please remember that every child is different. Some really take to sign language quickly and others have difficulty.Good luckmichael

>Here is my question: Is it typical for an autistic child to progress in some areas, such as eye contact, and physical contact, but remain stagnant in language and play skills?

Yes.

BTW, your description of your 4 year old is almost exactly the profile of my now 9 y.o. LFA when he was 4.

We did lots of floor time, parallel play, and not letting him zone too long on one thing. One thing I would do would be to imitate what he was doing (looking at pine cones, rocks, whatever) but at a distance, and very slowly getting closer, prompting him to take an interest in what I was doing and then, as much as he would tolerate it, doing it together. It took years but it worked. He now does parellel play at school with kids all the time, at playgraounds and such, and frequently does 1 0n 1 play, usually with games that have some kind of action he likes, such as Ker-plunk and Connect Four. It took time and patience but it wasn't really hard.

As for the speaking, we also do sign language and PCS, the picture thing, very useful at school for learning structures. We also make sure we prompt speech for making requests, gradually lengthening demands to be whole sentences. He still has severe apraxia, but when the motivation is strong enough, he can say "Please I want more Pizza," instead of just grabbing my hand and looking away and saying pizza. A lot of it was just lots and lots of fading of prompts day after day, year after year, and gently reminding him whenever he'd regress or forget.

Wow--reading your post was like reading my daughter's life. She is now 16 (dx'd at 25 months by doc, earlier by me), and is as happy as can be now. She still does not play nor speak, but she does love to people-watch. Numerous therapies have been tried over the years, but ABA programs worked the best. It took me several years to get her to tone down her arm-flapping and other such stimming behaviors, but it can be done. The "Patience of Job" is helpful too. Glad to meet you all!

Have you tried giving him DMG? or TMG? It has very good results in the language area. I put off giving it to my son because he never lost speech and I was not sure what it would do for him. When I finally did give it to him, he became much more socially aware and socially appropriate. Things I'd been asking him to do for years, he suddenly started doing without any prompting whatsoever.

For DMG to be effective you need to dose according to your child's weight. There is a table in Autism: Effective Biomedical Treatments, by Jon B. Pangborn, Ph.D. and Sidney M. Baker, M.D. Start low and increase gradually to theraputic levels.

I think your son sounds normal. we have had sucess with sign language, not so much with pecs. My son doesnt speak, but can answer questions with words (unprompted) that being said he still pulls us by the arm alot. we are thrilled that he has any words, so try to keep it in perspective. no offense, but I think the gf/cf diet is silly. some children start to speak as late as 8 Ive heard so dont give up hope!

Forgive my long post but the response about diet not working is putting me on my preaching stump:

Biomedical using DAN! approach coupled with an intense educational program {we do an ABA home program} WILL show improvement!!!

If I could do it over... I would start with the Elimination Diet {google it}, Houston's Naturaceuticals SCD Enzymes, and liquid Aloe from Warren Laboratories. Watch that your supplements are SCD versions... {that prevented our success for a long time}

It took us a long 1 &1/2 years to figure all the food sensivities that Ryan (3 & 1/2 years old} has.. Basically it wasn't until he was 3 years old that he had a normal bowel movement {prior: picture diarrhea up to his neck or down to his shoes, sometimes 10 times per day.} With each diet and finetuning of a diet we saw some improvement [GF/CF, SCD, modified SCD and today "Cave Man" diet] Now Ryan has perfect bowel movements as long as he maintains his current regimen and diet, ANY hint of grains (including rice and potato), casein, nuts, soy, corn, sugar, egg, or poultry and he regresses in his bowels and in his overall behavior... To give you an example, Ryan grabbed a handful of popcorn and about 4 hours later he was flapping, running in circles, and screaming at the top of his lungs... , the next day massive diarrhea... it took 5 days to return to baseline... A handful of dog food {gluten} had him screaming owy owy for hours through out the night... the next morning massive gas and diarrhea took 7 days to return to baseline... A fingerful of icing and 1 hour later he uncontrollably spun everything {including himself} until he feel asleep 7 hours later... immediate mild diarrhea... took 2 days to return to baseline.I can go on... as long as he stays on his diet, he sleeps through the night and has perfect poop and is making amazing progress {please note he could be the DAN!/ABA poster child given everything we do... but without diet/normal GI function... for him nothing can improve} I think the actual thinking from the DAN! doctors (my husband being one) is that even without noticable bowel problems (diarrhea or constipation} most of ASD kids have some degree of inflammatory bowel problems that respond to some extent to diet changes. If you start to feel overwelmed by how hard you think the diets may be... rethink... if you can find which foods your child is unable to process the rest of your life will improve 10 fold... Once you change your view, the work to do diet is not that hard... we cleaned house and only "legal" foods are within his reach... that makes the process much simpler. It takes me only 10 minutes to prepare a meal for him.Ryan he eats only organic beef but mainly lamb and lots of carrot juice {beta carotene research looks great in other neurological diseases.} He can only handle a small amount ((<4ozs non-box type only glass no concentrate grape or pineapple}} of other juices {we use organic grape juice for popcicles} Mainly he eats and snacks on frozen organic blueberries, strawberries, rasberries... and can have dehydrated "just tomato" organic fruits and Target brand organic fruit strips... lots of fresh organic apples and bananas, peaches, mango, cantalope, grapes, watermelon, blackberries... He went from little muscle tone and being "failure to strive" to in the 50% weight/height and good muscle tone in less about 6 months. In other posts I keep saying he is 4 but he is 3 & 1/2 {his sister is 4 ((4 & 1/2)).

Can I jump on the preaching stump as well? I started the GFCF diet when my son was almost 3. It did wonders for him...huge jumps in test scores and he stopped walking into walls and tripping on thin air. He started to sleep, he NEVER slept through the night. He stopped getting into his diapers and smearing feces everywhere. The screaming and vomiting stopped. He looked at me! I believe that all asd kids should be tested for celiac disease THEN decide whether or not to try the diet. Even if they are not celiac, the diet may work. In our case, my son was NEVER tested even though he had GI issues from the day I had to stop nursing him at 3 months of age. It took his little sister's vaccine injury at 3 years old to test HER for celiac and she was positive. I now feel confident saying that he needed the diet because he IS celiac. FYI, even on the diet though, he had 4 more years of diarrhea. When I finally convinced the knuckleheaded doctors to scope him he had eosinophilic esophagitis...allergic inflammation in his esophagus! Tried meds for 2 days but diarrhea was so bad I just couldn't do it...we did IgG food testing and eliminated ALL offending foods which cleared it completely. What should you do for your child? Research the pros & cons. It really isn't hard to feed nutritious food. You don't have to bake...the cave men didn't. When in doubt, give it a 6 month trial. You could be pleasantly surprised.